Anesthesia of the intensive-care patient

Mortality rates for healthy horses undergoing general anesthesia for routine procedures have been reported to range from 0.6% to 1.8%; these numbers increase as high as 5% when systemically ill horses are included in calculations. Anesthesia of intensivecare equine patients should first include critical assessment of the need for versus risk of anesthetic intervention. When general anesthesia cannot be avoided, the following measures should be considered and addressed throughout the perianesthetic period: preanesthetic assessment and cardiopulmonary stabilization, perianesthetic oxygen supplementation and ventilatory support, vigilant monitoring of the cardiopulmonary system, supportive therapy (ie, inotropic agents, fluids) to promote adequate cardiac output, use of perioperative adjunct systemic and/or regional agents to reduce inhalant requirements, close observation and assistance during recovery, and postoperative analgesia.